Functional Outcomes of Anorectal malformation: A 5 years Retrospective Study at single institution, Ethiopia.
| dc.contributor.advisor | Abay Gosaye | |
| dc.contributor.author | Gobena Mormata | |
| dc.date.accessioned | 2026-06-22T10:54:58Z | |
| dc.date.available | 2026-06-22T10:54:58Z | |
| dc.date.issued | 2025 | |
| dc.description.abstract | Anorectal malformation (ARM) is a wide spectrum of congenital malformation seen in pediatric patients. While the surgical techniques have advanced long term functional outcomes like voluntary bowel movement, soiling and constipations remain significant challenge for clinicians and patients especially in low income countries like Ethiopia. Objectives: To assess the functional outcomes of surgically reconstructed anorectal malformations and identifying factors affecting the outcomes at single tertiary institution in Ethiopia. Methodology: This is a retrospective cohort study which was conducted on 119 children treated for ARM over a 5-year period from September 2018 to September 2022. Functional outcomes was assessed using the Krickenbeck classification systems. Bivariate analysis was performed by using Chi-square, Fisher’s exact tests and Mann- Whitney U tests where they were appropriate according to the types of variables, then followed by multivariable logistic regression to identify independent affecting factors with Adjusted Odds Ratios [AOR] and 95% Confidence Intervals [CI]. Results: 84.9% of patients achieved VBM, while soiling and constipation were 47.1% and 24.4%, respectively. High ARM types were associated with higher soiling rates (77.8%; AOR 0.133, 95% CI: 0.031- 0.564, p=0.006). Conversely, low ARM type was associated with constipation (43.5%; AOR 8.4, 95% CI: 1.48-47.66, p=0.016). Redo anoplasty was associated with poor VBM (AOR 0.1, 95% CI: 0.02-0.49, p=0.005) and increased soiling (AOR 0.128, 95% CI: 0.028-0.582, p=0.008). While three-stage repairs showed higher soiling in bivariate analysis, multivariable analysis showed no independent effect. Early age at definitive surgery was associated with better voluntary bowel movement (AOR 0.97, 95% CI: 0.93-0.99, p=0.024). Conclusion and Recommendation: A functional outcome of ARM patients after surgical reconstruction at TASH is comparable to international studies. Types of ARM, redo anoplasty and age at definitive surgery were identified as independent affecting factors of the functional outcomes. However; neither stages of the surgery nor birth weight was independent affecting factor. So, the high rate of soiling need structured postoperative bowel management and follow-up. Early definitive surgery and decreasing of technical failures requiring reoperation are required for improving functional outcomes. | |
| dc.identifier.uri | https://etd.aau.edu.et/handle/123456789/8251 | |
| dc.language.iso | en | |
| dc.publisher | Addis Ababa Uinverstiy | |
| dc.subject | Anorectal Malformations | |
| dc.subject | Voluntary Bowel Movement | |
| dc.subject | Soiling | |
| dc.subject | Constipation | |
| dc.subject | Redo Anoplasty | |
| dc.subject | Functional Outcomes | |
| dc.subject | Ethiopia | |
| dc.subject | Pediatric Surgery | |
| dc.title | Functional Outcomes of Anorectal malformation: A 5 years Retrospective Study at single institution, Ethiopia. |